CA2961022A1 - Pasty two-component polymethacrylate bone cement - Google Patents
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- CA2961022A1 CA2961022A1 CA2961022A CA2961022A CA2961022A1 CA 2961022 A1 CA2961022 A1 CA 2961022A1 CA 2961022 A CA2961022 A CA 2961022A CA 2961022 A CA2961022 A CA 2961022A CA 2961022 A1 CA2961022 A1 CA 2961022A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
- A61L24/001—Use of materials characterised by their function or physical properties
- A61L24/0021—Plasticisers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
- A61K47/32—Macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds, e.g. carbomers, poly(meth)acrylates, or polyvinyl pyrrolidone
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
- A61L24/04—Surgical adhesives or cements; Adhesives for colostomy devices containing macromolecular materials
- A61L24/043—Mixtures of macromolecular materials
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
- A61L24/04—Surgical adhesives or cements; Adhesives for colostomy devices containing macromolecular materials
- A61L24/06—Surgical adhesives or cements; Adhesives for colostomy devices containing macromolecular materials obtained by reactions only involving carbon-to-carbon unsaturated bonds
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/14—Macromolecular materials
- A61L27/16—Macromolecular materials obtained by reactions only involving carbon-to-carbon unsaturated bonds
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- C—CHEMISTRY; METALLURGY
- C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
- C08F—MACROMOLECULAR COMPOUNDS OBTAINED BY REACTIONS ONLY INVOLVING CARBON-TO-CARBON UNSATURATED BONDS
- C08F265/00—Macromolecular compounds obtained by polymerising monomers on to polymers of unsaturated monocarboxylic acids or derivatives thereof as defined in group C08F20/00
- C08F265/04—Macromolecular compounds obtained by polymerising monomers on to polymers of unsaturated monocarboxylic acids or derivatives thereof as defined in group C08F20/00 on to polymers of esters
- C08F265/06—Polymerisation of acrylate or methacrylate esters on to polymers thereof
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
- A61L24/001—Use of materials characterised by their function or physical properties
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2430/00—Materials or treatment for tissue regeneration
- A61L2430/02—Materials or treatment for tissue regeneration for reconstruction of bones; weight-bearing implants
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Abstract
The invention proposes a pasty two-component polymethacrylate bone cement. Said bone cement comprising a pasty component A, containing Al at least one distillable methacrylate monomer for radical polymerisation; All at least one polymer that is soluble in Al; Alll at least one particulate polymer with a particle size of no more than 500 pm that is not soluble in Al; AIV at least one radical stabiliser; and AV at least one accelerator from the group of aromatic amines; and a pasty component B, containing BI dibenzoyl peroxide; Bll at least one substance that is not subject to radical polymerisation and is liquid at room temperature, whereby the solubility of dibenzoyl peroxide in this substance at room temperature is less than 5.0% by weight and, whereby the weight fraction of liquid substance Bll in the self-curing cement dough thus formed after the mixing of pasty component A with pasty component B is completed is less than 2.0% by weight. Moreover, the invention describes a method for producing a self-curing bone cement dough using the pasty two-component polymethacrylate bone cement.
Description
PASTY TWO-COMPONENT POLYMETHACRYLATE BONE CEMENT
The subject matter of the invention is a pasty two-component polymethacrylate bone cement.
Moreover, a method for producing a self-curing bone cement dough and the use of the pasty two-component polymethacrylate bone cement are subject matters of the invention.
Polymethacrylate bone cements have been in use in medicine for decades for permanent mechanical fixation of total joint endoprostheses. These are based on powder-liquid systems, whereby it is customary to use methylmethacrylate as monomer. A general overview is provided, e.g., in K.-D. Kuhn, "Bone Cements: Up-to-date Comparison of Physical and Chemical Properties of Commercial Materials", Springer-Verlag Berlin Heidelberg New York, 2000.
Aside from the powder-liquid cements, polymethylmethacrylate bone cements based on the use of cement pastes have also been proposed.
DE 10 2007 052116 Al relates to a one-component bone cement. DE 32 45 956 Al, 2007 050762 B3, and DE 10 2008 030312 Al describe two-component bone cements made of two cement pastes that are stored separately in suitable cartridges. Said pastes always contain one methacrylate monomer and at least one polymer dissolved therein. Moreover, said pastes can also contain cross-linked polymer particles that are insoluble in the methacrylate monomer.
Both pasty components separately contain components of a redox initiator system that react only after the two pasty components are mixed and, in the process, form radicals, which initiate the radical polymerisation of the methacrylate monomer that leads to the curing of the mixed cement dough. Redox initiator systems based on thermally stable hydroperoxides are particularly well-suited. EP 2 664 349 B1 describes a paste cement with a redox initiator system that is based on the use of hydroperoxides.
Proven for decades, the dibenzoyl peroxide/N-N-p-toluidine redox initiator system is suitable for pasty two-component polymethacrylate bone cements only to a limited degree, since the dibenzoyl peroxide dissolved in the liquid monomer always shows a low degree of spontaneous degradation that limits the storage time of the cement pastes. In the solid, undissolved aggregate state, dibenzoyl peroxide is clearly more stable during storage than in the dissolved state.
US 8,536,243 B2 describes a powder-gel bone cement system. This is a modification of the conventional powder-liquid bone cements. The powdered component consists of a polymer, an initiator such as dibenzoyl peroxide, and, if applicable, a radiopaquer, and hydroxyl apatite. The gel-like component comprises an acrylic monomer such as methylmethacrylate, a radical inhibitor such as hydroquinone, an activator such as N,N-dimethyl-p-toluidine, and a polymer that is dissolved in the acrylic monomer and has a mean molecular weight above1.000.000 g/mol. The dibenzoyl peroxide is present as a solid in the cement powder of this cement.
An analogous bone cement system is disclosed in US 2011 270 259 Al.
DE 10 2007 015698 B4 describes an implant material. Said implant material consists of a paste that is stable during storage and a monomer liquid that is stored separately.
The paste that is stable during storage is a mixture of at least one particulate polymer, a starter component for radical polymerisation, and a carrier liquid, in which the particulate polymer is not soluble and which does not swell, and in which the starter component is insoluble.
Relatively large weight fractions of carrier liquid are necessary in order to wet all of the cement powder and transfer it into a pasty state. Methylmethacrylate or other esters of methacrylic acid are proposed as separate monomer liquid. Dibenzoyl peroxide is used as starter component. The compressive strength of the cured implant material is relatively low and is below the requirements of ISO
5833 for the compressive strength being more than or equal to 70 MPa, as is illustrated by example 3 of DE 10 2007 015698 Al. Presumably, the underlying reason is that the carrier liquid is not miscible with the monomer liquid and does not partake in the radical polymerisation either. In this case, a porous implant material possessing only low mechanical strength is generated. Accordingly, the use of this implant material is hardly suitable for load-bearing permanent anchoring of articular endoprostheses.
It is the object of the invention to develop a pasty two-component polymethacrylate bone cement that contains dibenzoyl peroxide as initiator. Said bone cement is to be made up of two pasty components A and B, whereby pasty component A contains an accelerator and pasty component B contains the initiator and and has an appropriate composition such that it is stable during storage at room temperature. It is important for pasty component B to be present as a mass that is flowable mass when exposed to pressure and is suitable for being filled into cartridges by means of conventional paste filling machines.
The subject matter of the invention is a pasty two-component polymethacrylate bone cement.
Moreover, a method for producing a self-curing bone cement dough and the use of the pasty two-component polymethacrylate bone cement are subject matters of the invention.
Polymethacrylate bone cements have been in use in medicine for decades for permanent mechanical fixation of total joint endoprostheses. These are based on powder-liquid systems, whereby it is customary to use methylmethacrylate as monomer. A general overview is provided, e.g., in K.-D. Kuhn, "Bone Cements: Up-to-date Comparison of Physical and Chemical Properties of Commercial Materials", Springer-Verlag Berlin Heidelberg New York, 2000.
Aside from the powder-liquid cements, polymethylmethacrylate bone cements based on the use of cement pastes have also been proposed.
DE 10 2007 052116 Al relates to a one-component bone cement. DE 32 45 956 Al, 2007 050762 B3, and DE 10 2008 030312 Al describe two-component bone cements made of two cement pastes that are stored separately in suitable cartridges. Said pastes always contain one methacrylate monomer and at least one polymer dissolved therein. Moreover, said pastes can also contain cross-linked polymer particles that are insoluble in the methacrylate monomer.
Both pasty components separately contain components of a redox initiator system that react only after the two pasty components are mixed and, in the process, form radicals, which initiate the radical polymerisation of the methacrylate monomer that leads to the curing of the mixed cement dough. Redox initiator systems based on thermally stable hydroperoxides are particularly well-suited. EP 2 664 349 B1 describes a paste cement with a redox initiator system that is based on the use of hydroperoxides.
Proven for decades, the dibenzoyl peroxide/N-N-p-toluidine redox initiator system is suitable for pasty two-component polymethacrylate bone cements only to a limited degree, since the dibenzoyl peroxide dissolved in the liquid monomer always shows a low degree of spontaneous degradation that limits the storage time of the cement pastes. In the solid, undissolved aggregate state, dibenzoyl peroxide is clearly more stable during storage than in the dissolved state.
US 8,536,243 B2 describes a powder-gel bone cement system. This is a modification of the conventional powder-liquid bone cements. The powdered component consists of a polymer, an initiator such as dibenzoyl peroxide, and, if applicable, a radiopaquer, and hydroxyl apatite. The gel-like component comprises an acrylic monomer such as methylmethacrylate, a radical inhibitor such as hydroquinone, an activator such as N,N-dimethyl-p-toluidine, and a polymer that is dissolved in the acrylic monomer and has a mean molecular weight above1.000.000 g/mol. The dibenzoyl peroxide is present as a solid in the cement powder of this cement.
An analogous bone cement system is disclosed in US 2011 270 259 Al.
DE 10 2007 015698 B4 describes an implant material. Said implant material consists of a paste that is stable during storage and a monomer liquid that is stored separately.
The paste that is stable during storage is a mixture of at least one particulate polymer, a starter component for radical polymerisation, and a carrier liquid, in which the particulate polymer is not soluble and which does not swell, and in which the starter component is insoluble.
Relatively large weight fractions of carrier liquid are necessary in order to wet all of the cement powder and transfer it into a pasty state. Methylmethacrylate or other esters of methacrylic acid are proposed as separate monomer liquid. Dibenzoyl peroxide is used as starter component. The compressive strength of the cured implant material is relatively low and is below the requirements of ISO
5833 for the compressive strength being more than or equal to 70 MPa, as is illustrated by example 3 of DE 10 2007 015698 Al. Presumably, the underlying reason is that the carrier liquid is not miscible with the monomer liquid and does not partake in the radical polymerisation either. In this case, a porous implant material possessing only low mechanical strength is generated. Accordingly, the use of this implant material is hardly suitable for load-bearing permanent anchoring of articular endoprostheses.
It is the object of the invention to develop a pasty two-component polymethacrylate bone cement that contains dibenzoyl peroxide as initiator. Said bone cement is to be made up of two pasty components A and B, whereby pasty component A contains an accelerator and pasty component B contains the initiator and and has an appropriate composition such that it is stable during storage at room temperature. It is important for pasty component B to be present as a mass that is flowable mass when exposed to pressure and is suitable for being filled into cartridges by means of conventional paste filling machines.
2 ' CA 2961022 2017-03-15 It is another object of the invention to provide a pasty two-component polymethacrylate bone cement, whose cured cement dough, after the mixing of the two pasty cement components is completed, meets the requirements of ISO 5833, i.e. the compressive strength is more than or equal to 70 MPa, the flexural strength is more than or equal to 50 MPa, and the flexural modulus is more than or equal to 1800 MPa.
The object of the invention is met by a pasty two-component polymethacrylate bone cement according to claim 1.
According to the invention, a pasty two-component polymethacrylate bone cement comprises a pasty component A and a pasty component B. Pasty component A contains Al at least one distillable methacrylate monomer for radical polymerisation, All at least one polymer that is soluble in Al, AIII at least one particulate polymer with a particle size of no more than 500 pm that is not soluble in Al, AIV at least one radical stabiliser, and AV at least one accelerator from the group of aromatic amines. Pasty component B contains BI dibenzoyl peroxide, BII at least one substance that is not subject to radical polymerisation and is liquid at room temperature, whereby the solubility of dibenzoyl peroxide in this substance at room temperature is less than 5.0% by weight. In this context, the weight fraction of liquid substance Bit in the self-curing cement dough thus formed after the mixing of pasty component A with pasty component B is completed is less than 2.0% by weight.
The term, "comprise", as used in the present invention shall also include the meanings "to contain" and "to consist of" and "essentially consist of'. The term "contain"
shall also include the meanings "consists of and "essentially consist of'.
The particle size D50 shall be understood to be the volume average of the particle size. D50 is determined by means of a laser diffraction method using scattered light and the laser diffraction particle size analyzer LS 13320 made by Beckman Coulter, USA.
The number average molar mass is determined by means of gel permeation chromatography (GPC).
The object of the invention is met by a pasty two-component polymethacrylate bone cement according to claim 1.
According to the invention, a pasty two-component polymethacrylate bone cement comprises a pasty component A and a pasty component B. Pasty component A contains Al at least one distillable methacrylate monomer for radical polymerisation, All at least one polymer that is soluble in Al, AIII at least one particulate polymer with a particle size of no more than 500 pm that is not soluble in Al, AIV at least one radical stabiliser, and AV at least one accelerator from the group of aromatic amines. Pasty component B contains BI dibenzoyl peroxide, BII at least one substance that is not subject to radical polymerisation and is liquid at room temperature, whereby the solubility of dibenzoyl peroxide in this substance at room temperature is less than 5.0% by weight. In this context, the weight fraction of liquid substance Bit in the self-curing cement dough thus formed after the mixing of pasty component A with pasty component B is completed is less than 2.0% by weight.
The term, "comprise", as used in the present invention shall also include the meanings "to contain" and "to consist of" and "essentially consist of'. The term "contain"
shall also include the meanings "consists of and "essentially consist of'.
The particle size D50 shall be understood to be the volume average of the particle size. D50 is determined by means of a laser diffraction method using scattered light and the laser diffraction particle size analyzer LS 13320 made by Beckman Coulter, USA.
The number average molar mass is determined by means of gel permeation chromatography (GPC).
3 ' CA 2961022 2017-03-15 In the scope of the present invention, the term "methacrylate" shall be understood to mean alkyl ester of methacrylic acid. Esters of mono- and divalent alcohols with 1 to 4 carbon atoms are preferred. Pertinent examples are methylmethacrylate and ethylene glycol methacrylate.
The term "polymethacrylate" shall be understood to mean polymer of an alkyl ester of methacrylic acid. Polymers of the methyl and ethyl ester are preferred, i.e.
polymethyl methacrylate and polyethyl methacrylate, in particular polymethyl methacrylate.
The term, "soluble in methacrylate", shall be understood to mean that a solution that is clear to the eye is formed. This is determined visually by eye.
Referring to the methacrylate-insoluble particulate polymer that has a particle size 050 of at most 500 pm, the term, "insoluble in methacrylate", shall be understood to mean that no solution that is clear to the eye is formed. This is determined visually by eye.
The invention is based on finding, surprisingly and in contrast to the bone cement described in DE 10 2007 015698 B4, that pasty component B can be prepared from dibenzoyl peroxide and a substance, which is not subject to radical polymerisation and is liquid at room temperature and in which the solubility of dibenzoyl peroxide at room temperature is less than 5.0% by weight, without requiring polymeric particles or polymers that are dissolved in a solvent to allow for the formation of a paste. What is surprising in this context is that said paste can be plastically deformed without any difficulty and can be processed in the same manner as pastes that contain dissolved or suspended polymers. Said paste can be mixed without any difficulty with pastes that contain methacrylate monomers, in which dibenzoyl peroxide is soluble. It was evident, surprisingly, that pasty component B and pasty component A are very easy to mix, which is in contrast to the mixing of two pasty components, which both contain dissolved polymers.
It was also evident, surprisingly, that the mixing of pasty components A and B
of the two-component polymethacrylate bone cement according to the invention allow us a cement dough to be obtained that meets the requirements of ISO 5833 with regard to a compressive strength of more than or equal to 70 MPa, a flexural strength of more than or equal to 50 MPa, and a flexural modulus of more than or equal to 1800 MPa once it is cured.
The term "polymethacrylate" shall be understood to mean polymer of an alkyl ester of methacrylic acid. Polymers of the methyl and ethyl ester are preferred, i.e.
polymethyl methacrylate and polyethyl methacrylate, in particular polymethyl methacrylate.
The term, "soluble in methacrylate", shall be understood to mean that a solution that is clear to the eye is formed. This is determined visually by eye.
Referring to the methacrylate-insoluble particulate polymer that has a particle size 050 of at most 500 pm, the term, "insoluble in methacrylate", shall be understood to mean that no solution that is clear to the eye is formed. This is determined visually by eye.
The invention is based on finding, surprisingly and in contrast to the bone cement described in DE 10 2007 015698 B4, that pasty component B can be prepared from dibenzoyl peroxide and a substance, which is not subject to radical polymerisation and is liquid at room temperature and in which the solubility of dibenzoyl peroxide at room temperature is less than 5.0% by weight, without requiring polymeric particles or polymers that are dissolved in a solvent to allow for the formation of a paste. What is surprising in this context is that said paste can be plastically deformed without any difficulty and can be processed in the same manner as pastes that contain dissolved or suspended polymers. Said paste can be mixed without any difficulty with pastes that contain methacrylate monomers, in which dibenzoyl peroxide is soluble. It was evident, surprisingly, that pasty component B and pasty component A are very easy to mix, which is in contrast to the mixing of two pasty components, which both contain dissolved polymers.
It was also evident, surprisingly, that the mixing of pasty components A and B
of the two-component polymethacrylate bone cement according to the invention allow us a cement dough to be obtained that meets the requirements of ISO 5833 with regard to a compressive strength of more than or equal to 70 MPa, a flexural strength of more than or equal to 50 MPa, and a flexural modulus of more than or equal to 1800 MPa once it is cured.
4 = = CA 2961022 2017-03-15 Pasty components A and B can be stored in cartridges made of plastic material or in coated metal cartridges, in particular lacquered aluminium cartridges. The mixing of pasty components A and B to form a tack-free cement dough can be effected with a static mixer that is arranged in a dispensing tube connected to the cartridges on the cartridge head. The cartridges can be present as coaxial cartridges, as side-by-side cartridges or as individual cartridges that are not connected to each other, in which pasty components A and B are stored separately prior to mixing.
The paste used as component A comprises Al at least one distillable monomer for radical polymerisation. Examples of said monomers are, in particular, methacrylic acid esters.
Methylmethacrylate and ethylene glycol dimethacrylate are preferred as methacrylate monomer.
Methylmethacrylate is particularly preferred as distillable monomer for radical polymerisation.
The weight fraction of the monomer in component A can vary in broad ranges, whereby the weight fraction preferably is in the range of 10 to 70 wt.%. Preferably, the weight fraction of MMA in component A is in the range of 30 to 50 wt.%.
The paste used as component A further comprises All at least one polymer that is soluble in the distillable monomer for radical polymerisation. As a matter of principle, all methylmethacrylate-soluble polymers can be used. One or more methylmethacrylate-soluble polymers can be used.
Examples of suitable polymers include polymethylmethacrylate and copolymers of methylmethacrylate and one or more monomers that can be copolymerised with it, such as methylacrylate, styrene, and ethylacrylate. Polymethylmethacrylate, poly-methylmethacrylate-copolymers or mixtures thereof are preferred as polymer All, whereby polymethylmethacrylate-co-methylacrylate or polymethylmethacrylate-co-styrene are particularly preferred as polymer.
Preferably, the soluble polymer has a number average molar mass of less than 500,000 Dalton.
The number average molar mass of the at least one methacrylate-soluble polymer preferably is at least 100,000 Dalton.
The weight fraction of the at least one methacrylate-soluble polymer in component A can vary in broad ranges. It can, for example, be in the range of 15 to 45 wt.%, whereby the weight fraction preferably is in the range of 25 to 35 wt.%.
The paste used as component A further comprises at least one methacrylate-insoluble particulate polymer. Preferably, the methacrylate-insoluble particulate polymer has a density that differs only little from the density of methacrylate. As a result, there is little or virtually no sedimentation of insoluble polymer particles in paste A evident.
On principle, all polymers that are insoluble in methacrylate can be used as methacrylate-insoluble polymer particles. Examples of suitable polymers include cross-linked polymethylmethacrylate, cross-linked poly(methylmethacrylate-co-methacrylate), and cross-linked poly(methylmethacrylate-co-styrene).
Cross-linked polymethylmethacrylate and cross-linked poly(methylmethacrylate-co-methacrylate) are a copolymer of methylmethacrylate or a mixture of methylmethacrylate and methacrylate and one or more bifunctional, trifunctional and/or multi-functional monomers that can be copolymerised with it. Pertinent examples of said bifunctional, trifunctional and/or multi-functional monomers acting as cross-linkers include dimethacrylates, trimethacrylates, tetramethacrylates, diacrylates, triacrylates, tetraacrylates, whereby dimethacrylates are preferred.
Preferably, the methacrylate-insoluble particulate polymer is selected from the group consisting of cross-linked polymethylmethacrylate and cross-linked copolymers of methylmethacrylate. The methacrylate-insoluble particulate polymer AIII is particularly preferably selected from cross-linked polymethylmethacrylate and cross-linked poly-methylmethacrylate-co-methyl acrylate.
The weight fraction of AIII the at least one methacrylate-soluble particulate polymer in component A can vary in broad ranges. It can, for example, be in the range of 15 to 45 wt.%, whereby the weight fraction preferably is in the range of 25 to 35 wt.%.
It is particularly preferred according to the invention to have 30-50 parts by weight (Al), 25-35 parts by weight (All), and 25-35 parts by weight (AIII) present in pasty component A.
Particularly preferably, the weight ratio of pasty component A and pasty component 6 is more than or equal to 96 to 4, particularly preferably the weight ratio of component A and component B is between 94: 6 and 99.9 to 0.1.
Pasty component A is stored in cartridges in the absence of atmospheric oxygen. It contains AIV a radical stabiliser. Said radical stabiliser is preferably selected from the group consisting of p-benzoquinone (CAS no. 106-51-4), o-benzoquinone (CAS no. 583-63-1), hydroquinone (CAS
no.123-31-9), 2,5-di-t-butylhydroquinone (CAS no. 88-584), phenothiazine (CAS
no. 92-84-2) and the derivatives thereof. Preferably, the fraction of stabiliser present in component A is 0.01 to 1 wt.%.
Component A further contains AV at least one accelerator from the group of aromatic amines.
Preferably, the amine is a toluidine. In this context, the accelerator AV is particularly preferably selected from the group consisting of N,N-dimethyl-p-toluidine, N,N-bis-hydroxyethyl-p-toluidine and N,N-dimethyl-p-hydroxyethyl-aniline. Preferably, the content of the accelerator in component A ranges from 0.1 wt.% to 4 wt.%.
Advantageously, one or more optional additional substances can be contained in component A, e.g. one or more colouring substances and/or one or more pharmaceutical agents.
The pharmaceutical agents in pasty component A can be selected from the groups of antibiotics, hormones, growth factors, and antiphlogistic agents. Said pharmaceutical agents can be either soluble or insoluble in monomer Al. Antibiotics such as gentamicin sulfate, tobramycin sulfate, clindamycin hydrochloride, vancomycin hydrochloride, trometamol-fosfomycin, and daptomycin are preferred as pharmaceutical agents in this context.
Paste A can further contain one or more radiopaquers, which are also referred to as X-ray contrast agents. It is customary to use radiopaquers in bone cements and they are commercially available.
The radiopaquer can be, e.g., metal oxides, e.g. zirconium dioxide, barium sulfate, toxicologically non-objectionable heavy metal particles, e.g. tantalum, ferrite, and magnetite, or toxicologically non-objectionable calcium salts, e.g. CaCO3, CaS0.4 or CaSO4 2H20.
Preferably, the radiopaquer is selected from the group consisting of zirconium dioxide, barium sulfate, tantalum, and biocompatible calcium salts.
=
Moreover, component A can contain, as excipients, methacrylate-soluble colourants, methacrylate-insoluble colour pigments, pyrogenic silicon dioxide, and methacrylic amide. Food colourant E141 (chlorophyllin) is particularly well-suited as methylacrylate-soluble colourant.
Water, glycerol (CAS no. 56-81-5), diglycerol (CAS no. 627-82-7), glycerol-tri-octoate (CAS nor .528-23-8), glycerol-tri-decanoate (CAS no. 621-71-6), polyethylene glycol (CAS no. 25322-68-3), sebacic acid dibutylester (CAS no. 109-43-39) and mixtures thereof are preferred as liquid substance Bll that is not subject to radical polymerisation and is liquid at room temperature and normal pressure. The solubility of the dibenzoyl peroxide in these liquids at room temperature is less than 5% by weight. Mixed glycerol-triesters of octanoic acid and decanoic acid, which are commercially available by the brand name of Miglyol 812 (CAS no. 52622-27-2), are particularly well-suited. Upon mixing with particulate dibenzoyl peroxide, this liquid forms flowable pastes that can be moved particularly well in cartridges with small diameters due to the lubricating effect of the Miglyol 812. It is feasible just as well to use polar liquids such as water, glycerol, diglycerol, and polyethylene glycol. If these polar liquids are contained in component B
and component A is mixed with component B, said polar liquids lead to a somewhat delayed curing of the cement dough formed. Polyethylene glycol 200, polyethylene glycol 400, and polyethylene glycol 600 are conceivable as polyethylene glycol.
Preferably, component B contains hardly any biocompatible polymer powder, such as homo- or co-polymerisation products of acrylic and/or methacrylic esters, styrene, vinyl derivatives or mixtures thereof. Their content preferably is less than 0.1 wt.%, particularly preferably less than 0.01 wt.%, and even more particularly preferably less than 0.001 wt.%.
The weight ratio of dibenzoyl peroxide BI and liquid substance 611 is more than or equal to 1:1 and preferably more than or equal to 1:0.8.
Dibenzoyl peroxide BI has a sieved fraction with a grain size of less than or equal to 63 pm. By this means, uniform distribution of the dibenzoyl peroxide is attained when component B and component A are mixed with each other.
For colouring the mixed paste cement dough, pasty component B can have a colour pigment suspended in it that is insoluble in liquid substance BII. In this context, especially aluminium =
coloir lacquers, such as "color lacquer green", the aluminium colour lacquer of a mixture of food colourant E104 (quinoline yellow) and E132 (indigotine), are conceivable.
Pasty component A can be subjected to a sterilisation, e.g. by means of a sterilising agent. The paste can be sterilised, e.g., using the sterilisation method described in EP
2 59 6812 Al through the action of 13-propiolactone or the derivatives thereof. Paste B can be sterilised either by gamma irradiation, electron irradiation or by treatment with 11-propiolactone.
According to the invention, pasty component A is tack-free according to ISO
standard 5833 according to the "doctor's finger test". This ensures that the cement dough generated after the mixing of component A and component B is tack-free right away, without any waiting time, and can therefore be applied instantaneously.
The invention also relates to a method for producing a self-curing cement using the two-component polymethacrylate bone cement according to the invention, which comprises mixing pasty component A and pasty component B to form a self-curing cement dough.
The two components are preferably mixed at a weight ratio of 96 to 99.9 parts by weight of paste A to 0.1 to 4 parts by weight of paste B.
The mixing process of the two components can be separated in time from the extrusion process. The two components can be mixed, e.g. in a cartridge, such as a plastic cartridge, and the cement dough thus formed can be extruded using an extrusion device. For example, conventional, manually driven extrusion devices that are used with conventional two-component pasty bone cements as well are suitable for this purpose.
After the mixing of paste A and paste component B, a tack-free plastically deformable cement dough is generated immediately, without any waiting time, that self-cures by means of radical polymerisation.
The pasty two-component polymethacrylate bone cement according to the invention is used to particular advantage for the production of a means for the fixation of total articular endoprostheses and revision articular endoprostheses.
Moreover, the pasty two-component polymethacrylate bone cement is used for the production of a means for vertebroplasty, for kyphoplasty, for femoral neck augmentation, and for the production of spacers.
The pasty two-component polymethacrylate bone cement can also be used for the production of local agent release systems. These can take the shape of beads, bean-shaped spherical bodies, rods, tubes, and irregularly shaped bodies.
The invention shall be illustrated in more detail based on the following examples 1-5.
Production of pasty component A of examples 1-5:
Pasty component A of examples 1 to 5 was produced by mixing the ingredients specified in Table 1.
' .
Table 1:
Composition of pasty component A
Example 1 Example 2 Example 3 Example 4 Example 5 Methylmethacrylate 42.50 g 42.50 g 42.50 g 42.50 g 42.50 g Polymethylmethacrylate- 30.50 g 30.50 g 30.50 g 30.50 g 30.50 g co-methylacrylate Cross-linked polymethyl 15.45 g 15.45 g 15.45 g 15.45 g 15.45 g methacrylate Methacrylamide 0.40 g 0.40 g 0.40 g 0.40 g 0.40 g 2,5-Di-t- 50 mg 50 mg 50 mg 50 mg 50 mg butylhydroquinone N,N-Dimethyl-p-toluidine 0.35 g 0.35 g 0.35 g 0.35 g 0.35 g Green lacquer 5 mg 5 mg 5 mg 5 mg 5 mg Gentamicin sulfate - 1.47 - -Activity coefficient Clindamycin- - 1.50 - -hydrochloride Vancomycin - - - 1.50 -hydrochloride Trometamol-fosfomycin - - - - 1.50 Composition of pasty component B:
10.0 g BP (75%, phlegmatised with 25% by weight water) 4.0 g Mygliol The components of pasty component B of examples 1-5 were weighed in plastic cans, homogenised by stirring, and then closed in airtight manner with a screw lid.
The pasty components B were stored at room temperature in the air-tightly closed plastic cans until use.
The two components A and B were ground together until a colourless creamy-pasty mass was generated.
The substances of pasty components A and B were procured from Sigma-Aldrich with the exception of the soluble poly-methylmethacrylate-co-methylacrylate and the insoluble polymethylmethacrylate, which were made available by polymer manufacturers.
The trometamol-fosfomycin was procured from ZaChem S.p.A. Gentamicin sulfate from Fujian Fukang Ltd. (PR China) was used.
Production of test bodies:
ISO 5833 requires a flexural strength of 50 MPa, a flexural modulus of 1,800 MPa, and compressive strength of 70 MPa. Test bodies were produced for the test of the mechanical properties of the paste cements of examples 1-5 in accordance with ISO 5833. A
total of 40 g paste A were vigorously stirred with 1.40 g of each of the pasty component B
of examples 1-5.
An immediately tack-free green cement dough that cured by exothermic reaction after just a few minutes was thus produced immediately in all examples. Each cement dough of examples 1-5 was used to produce strip-shaped test bodies sized 75 mm x 10 mm x 3.3 mm for the test of the flexural strength and flexural modulus in accordance with ISO 5833. In addition, cylindrical test bodies (diameter 6 mm, height 12 mm) were manufactured for the compressive strength test.
After storage of the test bodies at 23 C and a relative humidity of 50 % for a period of 24 hours, the flexural strength, flexural modulus, and compressive strength were determined in accordance with ISO 5833. The results in Table 2 show that the mechanical requirements of ISO 5833 with regard to the flexural strength, flexural modulus, and compressive strength were met by the cements of examples 1-5.
Table 2:
Example Flexural strength Flexural modulus Compressive [MPa] [MPa] strength [MPa]
1 65.3 2.6 2651 84 97.1 3.2 2 62.8 1.6 2651 28 88.0 2.6 3 64.6 1.3 2712 43 93.3 3.7 4 62.1 2.5 2637 72 96.1 3.0 63.2 1.4 2575 70 88.8 1.8 Examples 6-10 Pasty component A and pasty component B were produced in the same manner as in examples 1-5, except that 0.1 wt.% R-propiolactone was added to each pasty component A
and pasty component B. Pasty component A and pasty component B were manually mixed with each other 2 weeks after their production and after storage at room temperature using the same mixing ratio as in examples 1-5. Similar to examples 1-5, a green, tack-free cement dough was produced that was plastically deformable for approximately 3 minutes and 30 seconds and then cured by exothermic reaction within approximately 4 minutes.
Examples 11-15 Pasty component A and pasty component B were produced in the same manner as in examples 6-10, except that 0.1 wt.% propiolactone was added to each pasty component A
and pasty component B. Pasty component A and pasty component B were placed in special side-by-site cartridges 2 weeks after their production and after storage at room temperature using the same mixing ratio as in examples 1-5. Subsequently, each of said cartridges was connected to a dispensing tube and to a static mixer arranged therein and then extruded with a manually operable extrusion device. Similar to examples 1-5, a green, immediately tack-free cement dough was produced during extrusion that was plastically deformable for approximately 3 minutes and 30 seconds and then cured by exothermic reaction within approximately 4 minutes.
Examples 16-20 A mixture of 10.0 g dibenzoyl peroxide (75%, phlegmatised with 25% by weight water) and 4.0 g glycerol was used as pasty component B. The composition of pasty component A
was the same as in examples 1-5. Pasty component A and pasty component B were placed in special side-by-site cartridges one day after their production and after storage at room temperature using the same mixing ratio as in examples 1-5. Subsequently, each of said cartridges was connected to a dispensing tube and to a static mixer arranged therein and then extruded with a manually operable extrusion device. Similar to examples 1-5, an immediately tack-free, green cement dough was produced during extrusion that was plastically deformable for approximately 4.5 minutes and then cured by exothermic reaction within approximately 4 minutes.
Examples 21-25 A mixture of 10.0g dibenzoyl peroxide (75%, phlegmatised with 25% by weight water) and 4.0 g water was used as pasty component B. The composition of pasty component A was the same as in examples 1-5. Pasty component A and pasty component B were placed in special side-by-site cartridges one day after their production and after storage at room temperature using the same mixing ratio as in examples 1-5. Subsequently, each of said cartridges was connected to a dispensing tube and to a static mixer arranged therein and then extruded with a manually operable extrusion device. Similar to examples 1-5, an immediately tack-free, green cement dough was produced during extrusion that was plastically deformable for approximately 4 to 5 minutes and then cured by exothermic reaction within approximately 4 minutes.
The paste used as component A comprises Al at least one distillable monomer for radical polymerisation. Examples of said monomers are, in particular, methacrylic acid esters.
Methylmethacrylate and ethylene glycol dimethacrylate are preferred as methacrylate monomer.
Methylmethacrylate is particularly preferred as distillable monomer for radical polymerisation.
The weight fraction of the monomer in component A can vary in broad ranges, whereby the weight fraction preferably is in the range of 10 to 70 wt.%. Preferably, the weight fraction of MMA in component A is in the range of 30 to 50 wt.%.
The paste used as component A further comprises All at least one polymer that is soluble in the distillable monomer for radical polymerisation. As a matter of principle, all methylmethacrylate-soluble polymers can be used. One or more methylmethacrylate-soluble polymers can be used.
Examples of suitable polymers include polymethylmethacrylate and copolymers of methylmethacrylate and one or more monomers that can be copolymerised with it, such as methylacrylate, styrene, and ethylacrylate. Polymethylmethacrylate, poly-methylmethacrylate-copolymers or mixtures thereof are preferred as polymer All, whereby polymethylmethacrylate-co-methylacrylate or polymethylmethacrylate-co-styrene are particularly preferred as polymer.
Preferably, the soluble polymer has a number average molar mass of less than 500,000 Dalton.
The number average molar mass of the at least one methacrylate-soluble polymer preferably is at least 100,000 Dalton.
The weight fraction of the at least one methacrylate-soluble polymer in component A can vary in broad ranges. It can, for example, be in the range of 15 to 45 wt.%, whereby the weight fraction preferably is in the range of 25 to 35 wt.%.
The paste used as component A further comprises at least one methacrylate-insoluble particulate polymer. Preferably, the methacrylate-insoluble particulate polymer has a density that differs only little from the density of methacrylate. As a result, there is little or virtually no sedimentation of insoluble polymer particles in paste A evident.
On principle, all polymers that are insoluble in methacrylate can be used as methacrylate-insoluble polymer particles. Examples of suitable polymers include cross-linked polymethylmethacrylate, cross-linked poly(methylmethacrylate-co-methacrylate), and cross-linked poly(methylmethacrylate-co-styrene).
Cross-linked polymethylmethacrylate and cross-linked poly(methylmethacrylate-co-methacrylate) are a copolymer of methylmethacrylate or a mixture of methylmethacrylate and methacrylate and one or more bifunctional, trifunctional and/or multi-functional monomers that can be copolymerised with it. Pertinent examples of said bifunctional, trifunctional and/or multi-functional monomers acting as cross-linkers include dimethacrylates, trimethacrylates, tetramethacrylates, diacrylates, triacrylates, tetraacrylates, whereby dimethacrylates are preferred.
Preferably, the methacrylate-insoluble particulate polymer is selected from the group consisting of cross-linked polymethylmethacrylate and cross-linked copolymers of methylmethacrylate. The methacrylate-insoluble particulate polymer AIII is particularly preferably selected from cross-linked polymethylmethacrylate and cross-linked poly-methylmethacrylate-co-methyl acrylate.
The weight fraction of AIII the at least one methacrylate-soluble particulate polymer in component A can vary in broad ranges. It can, for example, be in the range of 15 to 45 wt.%, whereby the weight fraction preferably is in the range of 25 to 35 wt.%.
It is particularly preferred according to the invention to have 30-50 parts by weight (Al), 25-35 parts by weight (All), and 25-35 parts by weight (AIII) present in pasty component A.
Particularly preferably, the weight ratio of pasty component A and pasty component 6 is more than or equal to 96 to 4, particularly preferably the weight ratio of component A and component B is between 94: 6 and 99.9 to 0.1.
Pasty component A is stored in cartridges in the absence of atmospheric oxygen. It contains AIV a radical stabiliser. Said radical stabiliser is preferably selected from the group consisting of p-benzoquinone (CAS no. 106-51-4), o-benzoquinone (CAS no. 583-63-1), hydroquinone (CAS
no.123-31-9), 2,5-di-t-butylhydroquinone (CAS no. 88-584), phenothiazine (CAS
no. 92-84-2) and the derivatives thereof. Preferably, the fraction of stabiliser present in component A is 0.01 to 1 wt.%.
Component A further contains AV at least one accelerator from the group of aromatic amines.
Preferably, the amine is a toluidine. In this context, the accelerator AV is particularly preferably selected from the group consisting of N,N-dimethyl-p-toluidine, N,N-bis-hydroxyethyl-p-toluidine and N,N-dimethyl-p-hydroxyethyl-aniline. Preferably, the content of the accelerator in component A ranges from 0.1 wt.% to 4 wt.%.
Advantageously, one or more optional additional substances can be contained in component A, e.g. one or more colouring substances and/or one or more pharmaceutical agents.
The pharmaceutical agents in pasty component A can be selected from the groups of antibiotics, hormones, growth factors, and antiphlogistic agents. Said pharmaceutical agents can be either soluble or insoluble in monomer Al. Antibiotics such as gentamicin sulfate, tobramycin sulfate, clindamycin hydrochloride, vancomycin hydrochloride, trometamol-fosfomycin, and daptomycin are preferred as pharmaceutical agents in this context.
Paste A can further contain one or more radiopaquers, which are also referred to as X-ray contrast agents. It is customary to use radiopaquers in bone cements and they are commercially available.
The radiopaquer can be, e.g., metal oxides, e.g. zirconium dioxide, barium sulfate, toxicologically non-objectionable heavy metal particles, e.g. tantalum, ferrite, and magnetite, or toxicologically non-objectionable calcium salts, e.g. CaCO3, CaS0.4 or CaSO4 2H20.
Preferably, the radiopaquer is selected from the group consisting of zirconium dioxide, barium sulfate, tantalum, and biocompatible calcium salts.
=
Moreover, component A can contain, as excipients, methacrylate-soluble colourants, methacrylate-insoluble colour pigments, pyrogenic silicon dioxide, and methacrylic amide. Food colourant E141 (chlorophyllin) is particularly well-suited as methylacrylate-soluble colourant.
Water, glycerol (CAS no. 56-81-5), diglycerol (CAS no. 627-82-7), glycerol-tri-octoate (CAS nor .528-23-8), glycerol-tri-decanoate (CAS no. 621-71-6), polyethylene glycol (CAS no. 25322-68-3), sebacic acid dibutylester (CAS no. 109-43-39) and mixtures thereof are preferred as liquid substance Bll that is not subject to radical polymerisation and is liquid at room temperature and normal pressure. The solubility of the dibenzoyl peroxide in these liquids at room temperature is less than 5% by weight. Mixed glycerol-triesters of octanoic acid and decanoic acid, which are commercially available by the brand name of Miglyol 812 (CAS no. 52622-27-2), are particularly well-suited. Upon mixing with particulate dibenzoyl peroxide, this liquid forms flowable pastes that can be moved particularly well in cartridges with small diameters due to the lubricating effect of the Miglyol 812. It is feasible just as well to use polar liquids such as water, glycerol, diglycerol, and polyethylene glycol. If these polar liquids are contained in component B
and component A is mixed with component B, said polar liquids lead to a somewhat delayed curing of the cement dough formed. Polyethylene glycol 200, polyethylene glycol 400, and polyethylene glycol 600 are conceivable as polyethylene glycol.
Preferably, component B contains hardly any biocompatible polymer powder, such as homo- or co-polymerisation products of acrylic and/or methacrylic esters, styrene, vinyl derivatives or mixtures thereof. Their content preferably is less than 0.1 wt.%, particularly preferably less than 0.01 wt.%, and even more particularly preferably less than 0.001 wt.%.
The weight ratio of dibenzoyl peroxide BI and liquid substance 611 is more than or equal to 1:1 and preferably more than or equal to 1:0.8.
Dibenzoyl peroxide BI has a sieved fraction with a grain size of less than or equal to 63 pm. By this means, uniform distribution of the dibenzoyl peroxide is attained when component B and component A are mixed with each other.
For colouring the mixed paste cement dough, pasty component B can have a colour pigment suspended in it that is insoluble in liquid substance BII. In this context, especially aluminium =
coloir lacquers, such as "color lacquer green", the aluminium colour lacquer of a mixture of food colourant E104 (quinoline yellow) and E132 (indigotine), are conceivable.
Pasty component A can be subjected to a sterilisation, e.g. by means of a sterilising agent. The paste can be sterilised, e.g., using the sterilisation method described in EP
2 59 6812 Al through the action of 13-propiolactone or the derivatives thereof. Paste B can be sterilised either by gamma irradiation, electron irradiation or by treatment with 11-propiolactone.
According to the invention, pasty component A is tack-free according to ISO
standard 5833 according to the "doctor's finger test". This ensures that the cement dough generated after the mixing of component A and component B is tack-free right away, without any waiting time, and can therefore be applied instantaneously.
The invention also relates to a method for producing a self-curing cement using the two-component polymethacrylate bone cement according to the invention, which comprises mixing pasty component A and pasty component B to form a self-curing cement dough.
The two components are preferably mixed at a weight ratio of 96 to 99.9 parts by weight of paste A to 0.1 to 4 parts by weight of paste B.
The mixing process of the two components can be separated in time from the extrusion process. The two components can be mixed, e.g. in a cartridge, such as a plastic cartridge, and the cement dough thus formed can be extruded using an extrusion device. For example, conventional, manually driven extrusion devices that are used with conventional two-component pasty bone cements as well are suitable for this purpose.
After the mixing of paste A and paste component B, a tack-free plastically deformable cement dough is generated immediately, without any waiting time, that self-cures by means of radical polymerisation.
The pasty two-component polymethacrylate bone cement according to the invention is used to particular advantage for the production of a means for the fixation of total articular endoprostheses and revision articular endoprostheses.
Moreover, the pasty two-component polymethacrylate bone cement is used for the production of a means for vertebroplasty, for kyphoplasty, for femoral neck augmentation, and for the production of spacers.
The pasty two-component polymethacrylate bone cement can also be used for the production of local agent release systems. These can take the shape of beads, bean-shaped spherical bodies, rods, tubes, and irregularly shaped bodies.
The invention shall be illustrated in more detail based on the following examples 1-5.
Production of pasty component A of examples 1-5:
Pasty component A of examples 1 to 5 was produced by mixing the ingredients specified in Table 1.
' .
Table 1:
Composition of pasty component A
Example 1 Example 2 Example 3 Example 4 Example 5 Methylmethacrylate 42.50 g 42.50 g 42.50 g 42.50 g 42.50 g Polymethylmethacrylate- 30.50 g 30.50 g 30.50 g 30.50 g 30.50 g co-methylacrylate Cross-linked polymethyl 15.45 g 15.45 g 15.45 g 15.45 g 15.45 g methacrylate Methacrylamide 0.40 g 0.40 g 0.40 g 0.40 g 0.40 g 2,5-Di-t- 50 mg 50 mg 50 mg 50 mg 50 mg butylhydroquinone N,N-Dimethyl-p-toluidine 0.35 g 0.35 g 0.35 g 0.35 g 0.35 g Green lacquer 5 mg 5 mg 5 mg 5 mg 5 mg Gentamicin sulfate - 1.47 - -Activity coefficient Clindamycin- - 1.50 - -hydrochloride Vancomycin - - - 1.50 -hydrochloride Trometamol-fosfomycin - - - - 1.50 Composition of pasty component B:
10.0 g BP (75%, phlegmatised with 25% by weight water) 4.0 g Mygliol The components of pasty component B of examples 1-5 were weighed in plastic cans, homogenised by stirring, and then closed in airtight manner with a screw lid.
The pasty components B were stored at room temperature in the air-tightly closed plastic cans until use.
The two components A and B were ground together until a colourless creamy-pasty mass was generated.
The substances of pasty components A and B were procured from Sigma-Aldrich with the exception of the soluble poly-methylmethacrylate-co-methylacrylate and the insoluble polymethylmethacrylate, which were made available by polymer manufacturers.
The trometamol-fosfomycin was procured from ZaChem S.p.A. Gentamicin sulfate from Fujian Fukang Ltd. (PR China) was used.
Production of test bodies:
ISO 5833 requires a flexural strength of 50 MPa, a flexural modulus of 1,800 MPa, and compressive strength of 70 MPa. Test bodies were produced for the test of the mechanical properties of the paste cements of examples 1-5 in accordance with ISO 5833. A
total of 40 g paste A were vigorously stirred with 1.40 g of each of the pasty component B
of examples 1-5.
An immediately tack-free green cement dough that cured by exothermic reaction after just a few minutes was thus produced immediately in all examples. Each cement dough of examples 1-5 was used to produce strip-shaped test bodies sized 75 mm x 10 mm x 3.3 mm for the test of the flexural strength and flexural modulus in accordance with ISO 5833. In addition, cylindrical test bodies (diameter 6 mm, height 12 mm) were manufactured for the compressive strength test.
After storage of the test bodies at 23 C and a relative humidity of 50 % for a period of 24 hours, the flexural strength, flexural modulus, and compressive strength were determined in accordance with ISO 5833. The results in Table 2 show that the mechanical requirements of ISO 5833 with regard to the flexural strength, flexural modulus, and compressive strength were met by the cements of examples 1-5.
Table 2:
Example Flexural strength Flexural modulus Compressive [MPa] [MPa] strength [MPa]
1 65.3 2.6 2651 84 97.1 3.2 2 62.8 1.6 2651 28 88.0 2.6 3 64.6 1.3 2712 43 93.3 3.7 4 62.1 2.5 2637 72 96.1 3.0 63.2 1.4 2575 70 88.8 1.8 Examples 6-10 Pasty component A and pasty component B were produced in the same manner as in examples 1-5, except that 0.1 wt.% R-propiolactone was added to each pasty component A
and pasty component B. Pasty component A and pasty component B were manually mixed with each other 2 weeks after their production and after storage at room temperature using the same mixing ratio as in examples 1-5. Similar to examples 1-5, a green, tack-free cement dough was produced that was plastically deformable for approximately 3 minutes and 30 seconds and then cured by exothermic reaction within approximately 4 minutes.
Examples 11-15 Pasty component A and pasty component B were produced in the same manner as in examples 6-10, except that 0.1 wt.% propiolactone was added to each pasty component A
and pasty component B. Pasty component A and pasty component B were placed in special side-by-site cartridges 2 weeks after their production and after storage at room temperature using the same mixing ratio as in examples 1-5. Subsequently, each of said cartridges was connected to a dispensing tube and to a static mixer arranged therein and then extruded with a manually operable extrusion device. Similar to examples 1-5, a green, immediately tack-free cement dough was produced during extrusion that was plastically deformable for approximately 3 minutes and 30 seconds and then cured by exothermic reaction within approximately 4 minutes.
Examples 16-20 A mixture of 10.0 g dibenzoyl peroxide (75%, phlegmatised with 25% by weight water) and 4.0 g glycerol was used as pasty component B. The composition of pasty component A
was the same as in examples 1-5. Pasty component A and pasty component B were placed in special side-by-site cartridges one day after their production and after storage at room temperature using the same mixing ratio as in examples 1-5. Subsequently, each of said cartridges was connected to a dispensing tube and to a static mixer arranged therein and then extruded with a manually operable extrusion device. Similar to examples 1-5, an immediately tack-free, green cement dough was produced during extrusion that was plastically deformable for approximately 4.5 minutes and then cured by exothermic reaction within approximately 4 minutes.
Examples 21-25 A mixture of 10.0g dibenzoyl peroxide (75%, phlegmatised with 25% by weight water) and 4.0 g water was used as pasty component B. The composition of pasty component A was the same as in examples 1-5. Pasty component A and pasty component B were placed in special side-by-site cartridges one day after their production and after storage at room temperature using the same mixing ratio as in examples 1-5. Subsequently, each of said cartridges was connected to a dispensing tube and to a static mixer arranged therein and then extruded with a manually operable extrusion device. Similar to examples 1-5, an immediately tack-free, green cement dough was produced during extrusion that was plastically deformable for approximately 4 to 5 minutes and then cured by exothermic reaction within approximately 4 minutes.
Claims (20)
1. Pasty two-component polymethacrylate bone cement comprising a pasty component A, containing Al at least one distillable methacrylate monomer for radical polymerisation;
All at least one polymer that is soluble in Al;
All I at least one particulate polymer with a particle size of no more than 500 pm that is not soluble in Al;
AIV at least one radical stabiliser; and AV at least one accelerator from the group of aromatic amines;
and a pasty component B, containing BI dibenzoyl peroxide;
BII at least one substance that is not subject to radical polymerisation and is liquid at room temperature, whereby the solubility of dibenzoyl peroxide in this substance at room temperature is less than 5.0% by weight;
whereby the weight fraction of liquid substance Bll in the self-curing cement dough thus formed after the mixing of pasty component A with pasty component B is completed is less than 2.0% by weight.
All at least one polymer that is soluble in Al;
All I at least one particulate polymer with a particle size of no more than 500 pm that is not soluble in Al;
AIV at least one radical stabiliser; and AV at least one accelerator from the group of aromatic amines;
and a pasty component B, containing BI dibenzoyl peroxide;
BII at least one substance that is not subject to radical polymerisation and is liquid at room temperature, whereby the solubility of dibenzoyl peroxide in this substance at room temperature is less than 5.0% by weight;
whereby the weight fraction of liquid substance Bll in the self-curing cement dough thus formed after the mixing of pasty component A with pasty component B is completed is less than 2.0% by weight.
2. Pasty two-component polymethacrylate bone cement according to claim 1, characterised in that pasty component A [contains]
Al 20- 60 wt.% of the at least one distillable methacrylate monomer for radical polymerisation;
All 15-45 wt.% of the at least one polymer that is soluble in Al;
Alll 15-45 wt.% of the at least one particulate polymer with a particle size of at most 500 µm that is not soluble in Al.
Al 20- 60 wt.% of the at least one distillable methacrylate monomer for radical polymerisation;
All 15-45 wt.% of the at least one polymer that is soluble in Al;
Alll 15-45 wt.% of the at least one particulate polymer with a particle size of at most 500 µm that is not soluble in Al.
3. Pasty two-component polymethacrylate bone cement according to any one of the preceding claims, characterised in that the weight ratio of dibenzoyl peroxide BI and liquid substance Bll is more than or equal to 1:1 and preferably is more than or equal to 2:1.
4. Pasty two-component polymethacrylate bone cement according to any one of the preceding claims, characterised in that the weight ratio of pasty component A and pasty component B is more than or equal to 96 to 4.
5. Pasty two-component polymethacrylate bone cement according to any one of the preceding claims, characterised in that Bll is selected from water, glycerol, diglycerol, glycerol-tri-octoate, glycerol-tri-decanoate, polyethylene glycol, sebacinc acid dibutylester, and mixtures thereof.
6. Pasty two-component polymethacrylate bone cement according to any one of the preceding claims, characterised in that BI dibenzoyl peroxide has a sieved fraction with a grain size of less than or equal to 63 pm.
7. Pasty two-component polymethacrylate bone cement according to any one of the preceding claims, characterised in that N,N-dimethyl-p-toluidine, N,N-bis-hydroxyethyl-p-toluidine, and N,N-dimethyl-p-hydroxyethyl-aniline are preferred as accelerator AV.
8. Pasty two-component polymethacrylate bone cement according to claim 1, characterised in that Al the methacrylate monomer is selected from the group consisting of methylmethacrylate and ethylene glycol dimethacrylate.
9. Pasty two-component polymethacrylate bone cement according to any one of the preceding claims, characterised in that polymer All is selected from the group of polymethylmethacrylate copolymers.
10. Pasty two-component polymethacrylate bone cement according to claim 9, characterised in that polymer All is selected from the group consisting of polymethylmethacrylate-co-methylacrylate and polymethylmethacrylate-co-styrene.
11. Pasty two-component polymethacrylate bone cement according to any one of the preceding claims, characterised in that All is selected from the group consisting of cross-linked polymethylmethacrylate and cross-linked polymethylmethacrylate-co-methylacrylate.
12. Pasty two-component polymethacrylate bone cement according to any one of the preceding claims, characterised in that the radical stabiliser AIV is selected from the group consisting of p-benzoquinone, o-benzoquinone, 2,5-di-t-butylhydroquinone, p-hydroquinone and phenothiazine.
13. Pasty two-component polymethacrylate bone cement according to any one of the preceding claims, characterised in that pasty component A contains, as excipients, one or substances selected from the group consisting of methacrylate-soluble colourants, methacrylate-insoluble colour pigments, pyrogenic silicon dioxide, and methacrylic amide.
14. Pasty two-component polymethacrylate bone cement according to any one of the preceding claims, characterised in that pasty component A contains one or more pharmaceutical agent(s) selected from the group consisting of antibiotics, hormones, growth factors, and antiphlogistic agents.
15. Pasty two-component polymethacrylate bone cement according to any one of the preceding claims, characterised in that pasty component A contains at least one radiopaquer selected from the group consisting of zirconium dioxide, barium sulfate, tantalum, and biocompatible calcium salts.
16. Pasty two-component polymethacrylate bone cement according to any one of the preceding claims, characterised in that a colour pigment that is insoluble in liquid substance Bll is suspended in pasty component B.
17. Method for producing a self-curing bone cement using the two-component polymethacrylate bone cement according to any one of the preceding claims, characterised in that pasty component A and pasty component B are mixed at a weight ratio of more than or equal to 96 to 4.
18. Use of the pasty two-component polymethacrylate bone cement according to any one of the claims 1 to 17 for the production of a means for fixation of total articular endoprostheses and revision articular endoprostheses.
19. Use of a pasty two-component polymethacrylate bone cement according to any one of the claims 1 to 17 for the production of a means for vertebroplasty, for kyphoplasty, for femoral neck augmentation, and for the production of spacers.
20. Use of the pasty two-component polymethacrylate bone cement according to any one of the claims 1 to 17 for the production of local agent release systems.
Applications Claiming Priority (2)
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DE102016209988.4A DE102016209988A1 (en) | 2016-06-07 | 2016-06-07 | Paste-like two-component polymethyl methacrylate bone cement |
DE102016209988.4 | 2016-06-07 |
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CA2961022A1 true CA2961022A1 (en) | 2017-12-07 |
CA2961022C CA2961022C (en) | 2019-05-14 |
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CA2961022A Active CA2961022C (en) | 2016-06-07 | 2017-03-15 | Pasty two-component polymethacrylate bone cement |
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US (1) | US10507261B2 (en) |
EP (1) | EP3254709B1 (en) |
JP (1) | JP6448700B2 (en) |
CN (1) | CN107469136B (en) |
AU (1) | AU2017201842B2 (en) |
CA (1) | CA2961022C (en) |
DE (1) | DE102016209988A1 (en) |
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CN114209872B (en) * | 2021-09-14 | 2022-11-22 | 上海意久泰医疗科技有限公司 | Two-component paste, application and preparation method of bone cement |
CN114209879B (en) * | 2021-12-28 | 2022-10-14 | 北京科技大学 | Composite bone cement material and preparation method thereof |
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FR1378816A (en) * | 1965-12-15 | 1964-11-20 | Elektrochem Werke Muenchen Ag | Delayed-acting oxidant, and its manufacturing process |
DE2842839C3 (en) * | 1978-10-02 | 1986-11-13 | NATEC Institut für naturwissenschaftlich-technische Dienste GmbH, 2000 Hamburg | Self-hardening compound based on polymethyl methacrylate and its use |
DE3245956A1 (en) | 1982-12-11 | 1984-06-14 | Beiersdorf Ag, 2000 Hamburg | SURGICAL MATERIAL |
CA2360319A1 (en) * | 1999-02-09 | 2000-08-17 | Memorial Sloan-Kettering Cancer Center | Anti-resorptive bone cements and allogeneic, autografic, and xenografic bone grafts |
DE102005032110B3 (en) * | 2005-07-07 | 2006-08-17 | Heraeus Kulzer Gmbh | Colored polymethyl-methacrylate cement to anchor endoprostheses in orthopoedic surgery incorporates a mixture of one or more dyes |
GB0517720D0 (en) | 2005-08-31 | 2005-10-05 | Lee Paul T H | Improved luggage |
DE102007015698B4 (en) * | 2007-03-27 | 2009-05-14 | Innotere Gmbh | Implant material based on a polymer system and its use as well as application set |
DE102007050762B3 (en) * | 2007-10-22 | 2009-05-07 | Heraeus Medical Gmbh | Paste polymethyl methacrylate bone cement and its use |
DE102007052116B4 (en) | 2007-10-22 | 2013-02-21 | Heraeus Medical Gmbh | One-component bone cement pastes, their use and methods of curing them |
DE102008030312A1 (en) | 2008-06-30 | 2010-01-14 | Heraeus Medical Gmbh | Polymethylmethacrylate-based paste used in single- or two-component bone cements or active substance release systems, has self-sterile composition |
DE102009043550A1 (en) * | 2009-09-30 | 2011-05-19 | Aap Biomaterials Gmbh | Bone cement and process for its preparation |
KR101031864B1 (en) | 2009-11-06 | 2011-05-02 | (주)인젝타 | Polymer -based bone cement using duality of paste-powder and loading apparatus thereof |
FR2957805B1 (en) | 2010-03-23 | 2012-04-20 | Teknimed | TWO COMPONENT SYSTEM FOR BONE CEMENT |
DE102010024653B4 (en) * | 2010-06-22 | 2012-06-21 | Heraeus Medical Gmbh | Kit for making bone cement and using this kit |
US20120265209A1 (en) * | 2011-04-13 | 2012-10-18 | Kyphon Sarl | Apparatus and methods for mixing materials |
JP5901156B2 (en) * | 2011-06-29 | 2016-04-06 | 地方独立行政法人東京都立産業技術研究センター | Inorganic organic composite particles and method for producing the same |
EP2596812B1 (en) | 2011-11-22 | 2015-06-10 | Heraeus Medical GmbH | Sterilisation of polymerisable monomers |
DE102012001636A1 (en) * | 2012-01-30 | 2013-08-01 | Heraeus Medical Gmbh | Pasty bone cement |
GB201205677D0 (en) | 2012-03-30 | 2012-05-16 | Internat Uk Ltd | A two part acrylic composition |
DK2664349T3 (en) | 2012-05-16 | 2016-05-02 | Heraeus Medical Gmbh | BONE LETTER IN PASTAFORM |
GB201317299D0 (en) * | 2013-09-30 | 2013-11-13 | Lucite Int Uk Ltd | A hardenable multi-part acrylic composition |
DE102014105267A1 (en) * | 2014-04-14 | 2015-10-15 | Heraeus Medical Gmbh | Polymethylmethacrylate bone cement |
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AU2017201842A1 (en) | 2017-12-21 |
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JP2017217454A (en) | 2017-12-14 |
CN107469136A (en) | 2017-12-15 |
EP3254709B1 (en) | 2020-02-26 |
CA2961022C (en) | 2019-05-14 |
CN107469136B (en) | 2021-02-09 |
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